Types of Diabetes

Types of Diabetes

Most people do not differentiate their diabetes from others. They usually think there is no difference between individual diabetes types. But this is not true — even two family members can have a different type of diabetes, and treatment varies according to the type. Every health-aware person must know this fact. The team of modern Endocrinologists of WHO divided this complex disease as follows.

Diabetes Type-1

What is Type-1 Diabetes?

It is a condition when the insulin secretion process stops due to some disturbance in the individual immune system, which destroys the beta cells of the pancreas — a gland located behind the stomach that secretes insulin. It mostly happens under the age of 20, but can occur at any age. 8–10% of the total diabetic population has Type-1 Diabetes, also known as Juvenile Diabetes.

Symptoms of Type-1 Diabetes

• Excessive thirst
• Increased frequency of urination
• Weakness
• Weight loss
• Increased appetite
• Itching or cuts in sex organs
• Itching and skin infections
• Nausea, abdominal discomfort or pain, and change in bowel movements may accompany acute DKA (Diabetic Ketoacidosis)
• Headaches
• Leg cramps

Risk Factors for Type-1 Diabetes

Some known risk factors include:

• Family history — plays an important role in Type-1 diabetes; presence of certain genes increases the risk of developing it
• The incidence of Type-1 diabetes tends to increase in migrant families
• First peak occurs from birth to four years, second peak between four to seven years, and third peak between ten to sixteen years

Some other possible risk factors are:

• Exposure to repeated viral infections, such as mumps virus and cytomegalovirus
• Early feeding of cow's milk instead of mother's breastfeed
• Deficiency of Vitamin D
• Mother having preeclampsia during pregnancy
• Being born with jaundice

Treatment of Type-1 Diabetes

Injectable insulin is the first choice of treatment. Your doctor will decide the dose and regime as per the requirement.

Type-1 Diabetes Emergency

As this type of diabetes is found mostly in children and teens, teamwork between the patient's parents and doctors is essential for better and long-lasting control, to avoid diabetic complications — both short-term and long-term — at an early stage.

There are two types of short-term complications or emergencies:

• Hypoglycaemia (low blood sugar level from normal)
• Diabetic Ketoacidosis (constant high blood sugar)

Long-Term Complications of Type-1 Diabetes

Long-term complications usually appear after 10 years of diabetic life.

• Diabetic Retinopathy (related to eyes)
• Diabetic Neuropathy (related to nerves)
• Diabetic Nephropathy (related to kidneys)
• Cardiovascular disease (related to the heart)

Diabetes Type-2

What is Type-2 Diabetes?

Diabetes Type-2 is a disease of malfunction of the pancreas — part of the digestive system located behind the stomach — which produces a secretion called insulin. Insulin is important to metabolise sugar and starch from diet and plays an important role in digestion and regulating blood sugar levels. The well-known role of insulin is to maintain the concentration of glucose in the blood and allow body cells to use glucose to generate energy for our day-to-day activities. When the pancreas is unable to make insulin, produces less insulin, or produces low-quality insulin that does not work as it should, Type-2 diabetes develops.

Causes of Type-2 Diabetes

• Genes
• Sedentary lifestyle
• Unhealthy food habits
• Overweight or obese
• Sustained mental stress
• Self-medication (steroid use for quick relief)
• Metabolic Syndrome

Symptoms of Type-2 Diabetes

• Fatigue
• Extreme thirst
• Frequent urination
• Extreme hunger
• Weight loss (with normal or excess food intake)
• Frequent infections of private parts
• Slow wound healing
• Blurry vision
• Long-lasting fever not responding to medication

It is not necessary that all symptoms will appear in every person — a patient may have only 2–3 symptoms.

Risk Factors of Diabetes Type-2

• Age 40 years or above
• Sedentary or inactive lifestyle
• Obese or overweight
• Family history — if a parent, brother, sister, or sibling has diabetes
• Migrant families moving to another country
• History of GDM (Gestational Diabetes Mellitus)
• Baby being underweight or overweight at birth
• Upper (systolic) BP above 140 mm Hg and lower (diastolic) BP above 90 mm Hg
• Triglycerides cholesterol level higher than 280 mg% and good cholesterol (HDL) less than 32 mg%
• Consuming rich diet and alcohol more than three days a week
• Regular severe stress
• Two or more high readings of fasting, postprandial, or random blood sugar in the last three months
• HbA1c level of 5.7 to 6.4% or blood sugar levels found high three times
• Female having polycystic ovary syndrome (PCOS or PCOD)
• Dark, velvety-black lines (acanthosis nigricans) around the neck or armpits
• History of cardiovascular disease

Gestational Diabetes Mellitus (GDM) — Type-3

Diabetes During Pregnancy

Gestational Diabetes is a Type-3 diabetes that can suddenly appear in about 4% of pregnant women. The hormonal changes of pregnancy stress the mother's system and, in some cases, interfere with the mother's insulin production. As a result, the mother develops high blood sugar levels, which can lead from miscarriage to congenital deformities in the newborn and pose a risk to the mother's life during pregnancy.

This type of diabetes usually disappears after the birth of the baby, but 20–40% of these women develop diabetes within 3 to 5 years. Knowing the risk factors is the first step towards prevention. Once you know you are at high risk, you can make efforts to reduce those risk factors, monitor your health, and consult your doctor at the right time.

Risk Factors for Gestational Diabetes

• Age above 30 years in first pregnancy
• Strong family history of diabetes (if mother or father has Type-1 diabetes, the risk is higher)
• Obesity
• Symptoms of diabetes (increased thirst, frequent urination, vaginal itching or infections, unexplained weakness) even with normal blood sugar
• History of miscarriage
• Previous stillbirth
• Previous birth of an overweight baby of 4 kg or more
• Polycystic ovarian syndrome (PCOS/PCOD)

How to Minimise the Risk of Gestational Diabetes

If you have more than three of the conditions described above and you are pregnant, you are at high risk. If you are planning to conceive, make proper preparations in advance.

Correct Your Lifestyle

Go for a morning walk of 15–30 minutes, five days a week, along with stretching exercises. If you are working, stay active in your office.

Take a Proper Diet

Maintain a four-hour gap between two meals. Avoid junk and high-calorie food, and reduce the number of cups of tea and coffee. Increase fresh fruits, green vegetables, sprouts, and cheese in your diet, or consult a qualified dietician. Avoid constipation.

Keep Yourself Hydrated

1–2 glasses of lemon juice per day along with 6–8 glasses of fresh water daily help eliminate bodily toxins.

Regular Check-ups

Start monitoring your blood sugar levels — fasting, after two hours of a meal, and HbA1c — to cross-check your blood sugar level of the last three months before conception, or as advised by your family doctor.

Medical Intervention

After getting pregnant, contact a professional medical team of doctors as early as possible to avoid any kind of complications related to gestational diabetes. Treatment for gestational diabetes ranges from diet management to insulin therapy. Some personalised complementary alternative medicines have also been found beneficial in maintaining blood sugar levels as well as for mother and child health.

Fourth Group — MRDM

MRDM (Malnutrition Related Diabetes Mellitus) was previously not found in India. But now some patients are being registered in metropolitan city hospitals. An imbalanced diet is the main cause of this condition.

Fifth Group

In this variety, pancreatic function is affected due to inflammatory conditions, stones, cysts, tumours, and similar issues. Stable diabetes and brittle diabetes represent this variety. One should understand the depth of diabetes and never attempt any medicine without consulting a Physician or Diabetologist.